Lipid Lowering Agents Flashcards
Atorvastatin
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs? (1)
Contraindications?
Class?
Lipid lowering agent
Mechanism?
HMG-CoA reductase inhibitor
Net effect?
decrease cholesterol syntheiss
increase LDL receptors - extracts more LDL/VLDL from serum
Clinical Uses?
treat elevated cholesterol levels/decrease total LDL
Side effects?
myopathy, rhabdomyolysis, hepatitis, abnormal LFTs,
Similar drugs?
lovastatin
Contraindications?
- additive effects with other lipid lowering agents
- any drug that inhibits CYP3A44 metabolism - accumulated toxicity
- patients that lack LDL receptors
Pregnancy Class X
Cholestyramine
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs?
Contraindications?
Class?
Lipid lowering agent
Mechanism?
inhibit reabsorption of bile acids in the jejunum and ileum
Net effect?
increased LDL receptors on the surface -> increased LDL extraction from the serum; reduces LDL by 10-20%
Clinical Uses?
treat elevated cholesterol levels, decrease LDL levels
Side effects?
Gi upset, decreased absorption of fat soluble vitamins (DEAK) and folic acid, impaired absorption with other drugs)
Similar drugs?
Contraindications?
patients who lack LDL receptors
may diminish absorption of statins, steroids, digoxin, and warfarin (DWSS)
Ezetimibe
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs?
Contraindications?
Class?
Lipid lowering agent
Mechanism?
decrease reabsorption of cholesterol in the small intestines
Net effect?
increased LDL receptors on the surface -> increased LDL extraction from the serum; reduces LDL by 20%
Clinical Uses?
hypercholesterolemia, decrease total + LDL levels
Side effects?
myalgia, elevated LFTs, diarrhea
Similar drugs?
Contraindications?
use with a bile acid sequestrant may decrease oral bioavailability
Gemfibrozil
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs? (1)
Contraindications?
Class?
Lipid lowering agent
Mechanism?
stimulate lipoprotein lipase
Net effect?
breakdown TG into vLDL and chylomicrons, which are removed from circulation
decrease hepatic cholesterol biosynthesis
Clinical Uses?
treat elevated cholesterol/TG levels
Side effects?
abnormal LFTs, GI upset, increase incidence of gallstone formation, myositis
Similar drugs?
fibrates
Contraindications?
therapeutic effects may be increased with statins, but this may also increase liver toxicity
Niacin (Vitamin B3)
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs?
Contraindications?
Class?
Lipid lowering agent
Mechanism?
decrease lipolysis in adipose tissue (decrease VLDL and LDL production)
inhibit apolipoprotein A1 breakdown (transports HDL)
Net effect?
increase HDL
Clinical Uses?
treatment of elevated cholesterol levels
Side effects?
Flushing (coadminister with aspirin), hyperuricemia (gout)
Similar drugs?
Contraindications?
pts taking cholestyramine (decreases absorption of Niacin)
Large first-pass effect
